The long-term aim of this program of research is to develop a Night Alert Prompting System (NAPS) that can be used by caregivers of home-dwelling cognitively impaired (CI) individuals to prevent nighttime injuries and unattended exits, improve caregiver sleep, reduce caregiver worry, and thereby delay institutionalization of the CI individuals. The primary function of NAPS is to notify the caregiver of the whereabouts of the CI individual in the home and to raise an alarm if the individual is in a potentially dangerous situation. This function is particularly important during the night when caregivers worry that they may sleep through potentially unsafe nighttime activity. The goal of Phase II of this project is to integrate the NAPS functionality into a microprocessor-based home security system and perform rigorous testing on reliability and clinical outcomes. The specific aims include making the necessary modifications to an existing home security control panel, developing a reliable bed-occupancy sensor, and developing a reliable method of data retrieval from the control panel for testing. In-home reliability testing of the modified system will be conducted. In addition, a pretest-posttest control group design will be used to evaluate the effect of NAPS on clinical outcomes, which include caregiver sleep, caregiver worry about nighttime activity, injuries to the CI individual, and unattended activity of the CI individual (particularly unattended exits from the home). The impact of NAPS on intent to place the CI individual in a nursing home will also be evaluated. Nighttime activity is a significant problem for home-dwelling CI individuals and their caregivers. The deleterious effects of nighttime activity on caregivers' sleep patterns and on their ability to continue to provide care, unfortunately lead to nursing home admission of the care recipient. The NAPS may be one means to delay institutionalization of the CI person, saving families and taxpayers large amounts of money.